362 APPLICATION OF METHODS OF BACTERIOLOGY 



causing death of the animals with inflammation of the men- 

 inges of the cord and brain. 



While the portal of entry for this organism to the system 

 is not known, it is still of importance to note that it often 

 makes its exit from the body by way of the organs that are 

 secondarily involved and that open to without, as the ear, 

 'nose, eye, and lungs. 



It is of equal importance to note that the organism is of 

 very low power of resistance, being destroyed in twenty- 

 four hours by direct sunlight and by drying at body-tem- 

 perature, and in seventy-two hours by drying in the dark 

 at ordinary room-temperature. 



For the diagnosis of epidemic cerebrospinal meningitis 

 by bacteriological methods it is essential that the meningeal 

 fluid be obtained by lumbar puncture during the most 

 acute stage of the disease. 



Antimeningitis Serxjm.i Flexner has demonstrated 

 that the blood serum of horses and of goats that have 

 received repeated subcutaneous injections of cultures of 

 diplococcus meningitidis possesses a marked restraining 

 action upon the course of meningitis. This is true not only 

 for the experimental manifestations of the disease, but for 

 those occurring in man as well. The analysis of about 400 

 cases of true epidemic cerebrospinal meningitis in man in 

 which the serum was used shows that the general death 

 rate was considerably lower than that following any other 

 known mode of treatment. For cases treated between the 

 flrst and third days of the disease it was as low as 16.5 per 

 cent., while for those treated as late as, and later than the 

 seventh day, it was 35 per cent,. Between these figures 



1 Flexner and Jobling, Arch, of Pediatrics, 1908, p. 747. 



